A Comparison of Studies on the Quality of Life of Primary Caregivers of Stroke Survivors: A Systematic Review of the Literature

349

235

Background: Health-related quality of life (HRQoL) is a recognized and important outcome after stroke. An increased survival and the presence of moderate impairment in long-term stroke survivors impact their HRQoL. Methods: HRQoL measures and HRQoL determinants in stroke survivors are reviewed. Results: Stroke is the leading cause of long-term disability in western countries. Specific HRQoL scales have been developed in the last years, such as the Stroke Impact Scale, the Stroke Specific Quality of Life Scale, the Stroke and Aphasia HRQoL Scale, and the Burden of Stroke Scale. Disability and poststroke depression are consistent determinants of HRQoL. Other determinants include female sex, coping strategies, and social support. Poststroke depression affects HRQoL, functional recovery, cognitive function and healthcare use in stroke survivors. Stroke caregivers have lower HRQoL, greater prevalence of stress and depression, economical burden, and changes in social relationships. Advancing age and anxiety in patients and caregivers, high dependency and poor family support identify caregivers at risk of adverse outcomes. Conclusions: Physical and psychosocial well-being is greatly affected in stroke survivors and their caregivers.

Section: Hrqol and Burden In Caregivers Of Stroke Patientsmentioning

confidence: 99%

Section: Hrqol and Burden In Caregivers Of Stroke Patientsmentioning

confidence: 99%

Quality of Life after Stroke: The Importance of a Good Recovery

Carod-Artal

Egido²

2009

349

235

“…The financial and psychological instability that accompanies negative life events may reveal or revive latent weaknesses that otherwise would not appear and would not affect health. The quality of life of caregivers can be explored using the short version of the World Health Organization Quality of Life – bref (Whoqol-bref), a multidimensional generic profile designed for different cultural contexts and populations [29,30]. It was applied to caregivers in the immediate discharge period [31].…”

Section: Introductionmentioning

confidence: 99%

Life Satisfaction of Two-Year Post-Stroke Survivors: Effects of Socio-Economic Factors, Motor Impairment, Newcastle Stroke-Specific Quality of Life Measure and World Health Organization Quality of Life – bref of Informal Caregivers in Luxembourg and a Rural Area in Portugal

Baumann

Lurbe

Leandro³

et al. 2012

Background: Life satisfaction of stroke survivors is known to be associated with socio-economic factors and the survivor’s and his/her caregiver’s quality of life, but their respective influence remains to be fully elucidated. Purpose: To analyse the stroke survivors’ life satisfaction 2 years after the event and its relationships with quality of life, socio-economic and stroke-related characteristics, and with informal caregivers’ life satisfaction and quality of life . Methods: Over 18 months, all stroke patients from Luxembourg and north-eastern Portugal who lived at home were identified from the Inspection Générale de la Sécurité Sociale and hospital records, respectively. The clinical diagnosis of cerebrovascular disease was confirmed. We excluded all patients who declared that stroke did not result in neurological impairments at the time of stroke from the statistical analysis. The samples comprised 79 patients in Luxembourg and 48 in Portugal. Patients and the people they identified as their main caregivers were interviewed using validated questionnaires measuring life satisfaction, i.e. the Newcastle Stroke-Specific Quality of Life (Newsqol – 11 subscales), which identifies the areas affected by stroke among patients, and the World Health Organization Quality of Life – bref (Whoqol-bref – 4 subscales) of informal caregivers. Survivors without neurological impairment at the time of stroke were excluded. Data were analysed via multiple-regression models. Results: Life satisfaction was higher among women and lower among subjects with impaired motor functions. It was lower among Portuguese respondents with low-level education (<12th grade) and higher among those at work (37.6/100). In Luxembourg, retired people had more life satisfaction than did working people (–7.9/100). Controlling for socio-economic factors, life satisfaction was associated with feelings- Newsqol (slope 0.25) among Luxembourg residents, and with feelings-, mobility- and self-care-Newsqol (slopes 0.24, 0.27 and 0.33, respectively) among Portuguese respondents. Life satisfaction of patients was strongly related to that of family caregivers among the Portuguese respondents (slope 0.66) but the relationship was moderate in Luxembourg (slope 0.28). The survivors’ life satisfaction was not correlated with any Whoqol-bref domain in the Luxembourg group, but was correlated with the Whoqol-bref psychological, social relationships and environment domains among the Portuguese respondents (slopes 0.55, 0.59 and 0.51, respectively). Conclusions: The life satisfaction scale and the Newsqol stroke instrument, which identify areas of quality of life affected by stroke, are reliable patient-centred markers of intervention outcome. They can be used within the framework of medical follow-up (such as telephone assistance, clinical practice and prevention). Depending on the stroke survivor’s and the family caregiver’s habitual lifestyle and material circumstances, enhancement of a caregiver’s quality of life can help maintain the patient’s life satisfaction, ...

“…Health status of stroke survivors, the amount of direct care, the help and support that caregiver obtained from family and society influence their perceived level of burden [3, 4]. The majority of caregivers are women and spouses, and older caregivers experience more comorbidities compared to younger caregivers.…”

Section: Introductionmentioning

confidence: 99%

Burden and Perceived Health Status Among Caregivers of Stroke Patients

Carod-Artal¹,

Coral²,

Trizotto³

et al. 2009

Objective: To identify the main determinants of burden and perceived health status in caregivers of Brazilian stroke survivors. Methods: Cross-sectional study. Caregivers answered the Hospital Anxiety and Depression Scale (HADS), Zarit caregiver burden interview (ZCBI) and EuroQol. Patients were assessed with the National Institute of Health Stroke Scale, Barthel index (BI), modified-Rankin scale (m-RS), Mini Mental State Examination and HADS. Results: 200 caregiver-patient dyads were assessed. Caregivers were significantly younger (42 vs. 57.7 years) and had more years of formal education (10 vs. 7.8 years); p < 0.0001. Seventy-seven percent of caregivers were females, and 41% were spouses. The prevalence of anxiety disorders was significantly higher in female caregivers than in males (26.1 vs. 10.9%; p = 0.04). ZCBI mean score was 27.2, and female caregivers had significantly worse scores (28.7 vs. 22.3, p = 0.003). ZCBI mean score significantly increased (worsened) as the severity of the disease, based on m-RS, increased. ZCBI mean scores were significantly higher in wives than in other relatives (31.4 vs. 22.6; ANOVA, p < 0.0001). The EuroQol-5D and EuroQol-Visual Analog Scale mean scores were 0.7 (range: 0.04–0.85) and 75.2 (range: 1–100), respectively. Adequate convergent validity (r = –0.38 to –0.40) between EuroQol and ZBCI mean scores was observed. Patient´s disability (as measured by the BI) and caregiver’s factors (female sex, depression as measured by HADS-depression) were independent predictors of caregiver’s burden (r² adjusted = 0.48; p < 0.0001) in the multivariate regression analysis. Conclusions: Caregiver’s mood was the most consistent factor influencing caregiver burden and perceived health in stroke caregivers.